Tỷ lệ nhiễm và gen kháng thuốc metallo-β-lactamase NDM, IMP, VIM của một số trực khuẩn Gram âm trên bệnh nhân viêm phổi tại Bệnh viện Đa khoa Thành phố Cần Thơ năm 2022-2023=Infectious prevalence and distribution of metallo-β-lactamase NDM, IMP, vim genes in gram-negative bacteria isolated from pneumonia patients at Can Tho city general hospital in 2022-2023

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Tác giả: Thị Xuân Liễu Hồng, Thị Thúy An Lê, Dương Hiển Nguyễn, Thị Cẩm Hồng Nguyễn, Thị Tuyền Nguyễn, Thị Ngọc Nga Phạm, Đỗ Hùng Trần, Phước Thịnh Trần, Thị Hồng Của Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y dược học Cần Thơ, 2024

Mô tả vật lý: tr.195-202

Bộ sưu tập: Metadata

ID: 245165

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In recent years, Gram-negative bacteria causing pneumonia have shown an increasing resistance to carbapenem antibiotics due to the rising production of metallo-β-lactamase (MBL) enzymes. Objectives: To determine the prevalence and carriage rate of MBL resistance genes, including the three types of genes: imipenemase (IMP), Verona integron-encoded MBLs (VIM), and New Delhi metallo-β-lactamase (NDM), in gram-negative bacteria Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa, isolated from lower respiratory tract specimens of patients with pneumonia. Materials and methods: A cross-sectional descriptive study was conducted on 92 patients diagnosed with pneumonia caused by A. baumannii, E. coli, P. aeruginosa, and K. pneumoniae from August 2022 to April 2023 at the Can Tho City General Hospital. Bacterial isolates were cultured and identified from lower respiratory tract specimens using an automated system, and a real-time PCR technique was employed to detect MBL resistance genes, including three genotypes: VIM, IMP, and NDM. Result: Among the 92 isolated Gram-negative bacteria, the infection rates of K. pneumoniae, A. baumannii, E. coli, and P. aeruginosa were 34.4%, 29.2%, 20.8%, and 11.5%, respectively. Of these, 62 (67.4%) Gram-negative bacteria carried MBL genes, including 3 genotypes: NDM, IMP, and VIM, with prevalence rates of 96.8%, 32.3%, and 1.6%, respectively. Conclusion: K. pneumoniae and A. baumannii were the most common Gram-negative bacteria found in pneumonia patients. Approximately 70% of the Gramnegative bacteria in this study carried MBL resistance genes, with the NDM genotype appearing in most of these bacteria. K. pneumoniae strains carrying all three MBL genes were observed, and P. aeruginosa in this study consistently carried at least one MBL genotype.Trong những năm gần đây, các trực khuẩn Gram âm gây bệnh viêm phổi với mức độ đề kháng kháng sinh nhóm carbapenem ngày càng cao do sự gia tăng khả năng sản sinh men metallo-β-lactamase (MBL). Mục tiêu nghiên cứu: Xác định tỷ lệ nhiễm và tỷ lệ mang gen kháng thuốc MBL, gồm 3 kiểu gen imipenemase (IMP), Verona integron-encoded MBLs (VIM), New Delhi metallo-β-lactamase (NDM) trên các trực khuẩn gram âm Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa và Klebsiella pneumoniae, phân lập từ mẫu bệnh phẩm đường hô hấp dưới ở bệnh nhân viêm phổi. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang được thực hiện trên 92 bệnh nhân được chẩn đoán viêm phổi với tác nhân gây bệnh là A. baumannii, E. coli, P. aeruginosa và K. pneumoniae từ tháng 8/2022 đến tháng 4/2023 tại Bệnh viện Đa khoa thành phố Cần Thơ. Thực hiện nuôi cấy phân lập và định danh vi khuẩn từ mẫu bệnh phẩm đường hô hấp dưới bằng hệ thống tự động, và kỹ thuật real-time PCR phát hiện gen kháng thuốc MBL bao gồm 3 kiểu gen VIM, IMP, NDM. Kết quả: Trong 92 trực khuẩn Gram âm phân lập được, tỷ lệ nhiễm của K. pneumoniae, A. baumannii, E. coli và P. aeruginosa lần lượt là 34,4%, 29,2%, 20,8% và 11,5%. Trong đó, có 62 (67,4%) trực khuẩn Gram âm mang gen MBL, bao gồm 3 kiểu gen NDM, IMP và VIM với tỷ lệ lần lượt là 96,8%, 32,3% và 1,6%. Kết luận: K. pneumoniae và A. baumannii thường gặp nhất ở bệnh nhân viêm phổi với tác nhân là trực khuẩn Gram âm. Khoảng 70% số trực khuẩn Gram âm trong nghiên cứu này có mang gen kháng thuốc MBL và kiểu gen NDM xuất hiện ở hầu hết các trực khuẩn Gram âm này. Xuất hiện chủng K. pneumoniae mang tổ hợp cả ba gen MBL, và P. aeruginosa trong nghiên cứu này luôn mang ít nhất một kiểu gen MBL.

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